Implantable intervertebral disc shearing device

ABSTRACT

An implantable device for stabilizing joints is provided. The stabilizing device, or implant, includes an elongated body and at least two bone cutting surfaces. The bone cutting surfaces are adapted to cut bone upon rotation of the body about its longitudinal axis between two bones. The device is adapted to promote bone fusion. In one embodiment, a device to initiate bony fusion between two adjacent vertebral bodies in the spine is provided. Methods of stabilizing joints and promoting bone fusion are also provided.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of co-pending U.S. patent applicationSer. No. 10/669,951, which was filed on Sep. 24, 2003, which claims thebenefit of U.S. Provisional Patent Application No. 60/413,111, which wasfiled on Sep. 24, 2002, and which are all incorporated herein byreference.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention pertains to surgical stabilizing devices and proceduresfor stabilizing joints within the spine, and other joints. Moreparticularly, this invention pertains to a novel stabilizing device thatutilizes one or more local bone autografts harvested during theimplantation procedure.

2. Description of the Related Art

The treatment of back pain can be relieved by preventing relative motionbetween spinal vertebrae. Intervertebral stabilization achieved by theuse of spine cages, intervertebral spacers, and bone grafts forinsertion into the space formerly occupied by a degenerated disc areknown in the art. These devices may involve mechanically coupling theadjacent vertebrae or by promoting fusion between them. Accordingly,such techniques are used to stabilize the spine and reduce pain byrigidly joining two adjacent vertebrae that oppose a degenerated disc ordegenerated posterior elements of the vertebrae (e.g. facet joints).

SUMMARY OF THE INVENTION

In one embodiment of the current invention, an implantable stabilizingdevice for stabilizing two adjacent vertebral bodies in the human spineis provided. The stabilizing device, or implant, comprises an elongatedbody, having a longitudinal axis and a transverse axis, and at least twobone cutting surfaces. In one embodiment, the elongated body has a firstbone cutting surface and a second bone cutting surface that are offsetfrom the longitudinal axis of the body. The first bone cutting surfacefaces in a first direction, and the second bone cutting surface faces ina second direction. The first bone cutting surface and/or the secondbone cutting surface is adapted to cut bone upon rotation of the bodyabout its longitudinal axis between two adjacent vertebral bodies.

In several embodiments, the bone cutting surfaces are blades orblade-like surfaces. In one embodiment, the first bone cutting surface,the second bone cutting surface and/or the elongated body has one ormore perforations, holes, or voids. In another embodiment, the firstbone cutting surface, the second bone cutting surface and/or theelongated body is made of a material that is at least partially porous.

In one embodiment, at least a portion of the elongated body is hollow.In some embodiments, the elongated body is a support member that servesto connect two bone cutting blades.

In one embodiment, at least one bone cutting surface comprises one ormore teeth. In another embodiment, at least one bone cutting surface iscurved inward relative to the elongated body. In one embodiment, atleast one bone cutting surface is sharpened. In another embodiment, atleast one bone cutting surface is blunt.

In several embodiments, a portion of a bone cutting surface and/or theelongated body includes at least one shearing means or protrusions.Protrusions include, but are not limited to, barbs, spikes and wedges.In some embodiments, a portion of a bone cutting surface and/or theelongated body is treated with a surface treatment. The surfacetreatment includes, but is not limited to, bone growth facilitator(e.g., bone morphogenic protein) and/or adhesives (e.g., cyanoacrylate).In one embodiment, the implantable stabilizing device further includes asource or supply of bone growth facilitator.

In several embodiments, a portion of a bone cutting surface and/or theelongated body is constructed from a biocompatible material, includingbut not limited to titanium, steel, plastic, and ceramic.

In one embodiment of the present invention, an implantable device forstabilizing a joint is provided. In one embodiment, the joint is aspinal joint. In other embodiments, the joint is in the shoulder, wrist,ankle, knee, hip, or digits. In several embodiments, the implantabledevice, or implant, comprises a first bone cutting surface and a secondbone cutting surface that are connected by a support member.

In one embodiment, the bone cutting surfaces include a first leadingedge, a first trailing edge, a first top edge and a first bottom edge.The support member comprises a length that is mounted perpendicular tothe first bone cutting surface and the second bone cutting surface andis spaced from said first bone cutting surface and second bone cuttingsurface by a distance in the range of about 1 cm to about 5 cm. At leastone of the bone cutting surfaces is adapted to accept a local boneautograft.

In one embodiment, at least one of bone cutting surface is a blade. Inanother embodiment, at least one of bone cutting surface is a blade iscurved inward relative to the support member.

In some embodiments, at least one edge of at least one bone cuttingsurface is sharpened. In some embodiments, at least one edge of at leastone bone cutting surface is blunt. In one embodiment, the leading edgesof both bone cutting surfaces is sharp.

In one embodiment, an implantable stabilizing device for stabilizing twoadjacent vertebral bodies in the human spine is provided. In oneembodiment, the stabilizing device, or implant, comprises an elongatedbody having a longitudinal axis and a transverse axis, a first shearingmeans on the elongated body offset from the longitudinal axis and asecond shearing means on the elongated body offset from the longitudinalaxis. The first shearing means faces in a first direction, and thesecond shearing means faces in a second direction. At least one of theshearing means is adapted to shear bone upon rotation of the body aboutits longitudinal axis between two adjacent vertebral bodies.

In one embodiment of the present invention, a method of initiating bonyfusion between a first bone and a second bone is provided. In oneembodiment, an implant having a body with a longitudinal axis, and atleast a first bone cutter and a second bone cutter offset in oppositetransverse directions from the longitudinal axis is provided. Theimplant is introduced between the first and second bones and rotatedabout its longitudinal axis so that the first and second bone cutterscut fragments from the first and second bones. The implant is left inposition between the first and second bones. In one embodiment, a bonegrowth facilitator is infused through at least a portion of the implant.In some embodiments, a second implant is inserted in between the firstand second bones.

In one embodiment, bony fusion is initiated between adjacent vertebralbodies. In one embodiment, at least one of the first and secondvertebral bodies is in the sacral spine, lumbar spine or cervical spine.

In one embodiment, the implant is rotated through no more than onerevolution. In another embodiment, the implant is rotated through nomore than about 120 degrees. In another embodiment, rotation is stoppedat a point where the first bone cutter is in contact with the first boneand the second bone cutter is in contact with the second bone.

In one embodiment of the current invention, a method of stabilizing twoadjacent vertebral bodies is provided. In one embodiment, a stabilizingdevice having a first bone cutting surface and a second bone cuttingsurface connected by a support member is provided. The bone cuttingsurfaces comprise a leading edge, a trailing edge, a top horizontal edgeand a bottom horizontal edge. The stabilizing device is oriented suchthat the bone cutting surface are perpendicular to the endplates of saidvertebral bodies and the support member is parallel to said endplates.The stabilizing device is inserted into and across the endplates suchthat at least a portion of at least one of the endplates is lodgedbetween the bone cutting surface. The stabilizing device is rotated suchthat at least one of the endplates is translocated perpendicular to itsoriginal location.

In one embodiment of the invention, a method of promoting bony fusionbetween a first bone and a second bone is provided. One or more implantshaving a body with a longitudinal axis, and at least a first shearingmeans and a second shearing means offset in opposite transversedirections from the longitudinal axis is provided. The implants areintroduced in between the first and second bones. At least one of theimplants is rotated about its longitudinal axis so that the first andsecond shearing means shear one or more fragments from the first andsecond bones. At least one or more implants in left in position betweenthe first and second bones.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a sagittal view of functional spinal unit.

FIG. 2 shows a sagittal view of functional spinal unit with a herniateddisc.

FIG. 3 shows a front cross-sectional view of a functional spinal unit.

FIG. 4A, which presents an isometric view of an embodiment of theinvention, FIGS. 4B and C show front view of different cross-sections ofan embodiment of the invention.

FIG. 5 is an isometric view of an alternative embodiment of theinvention.

FIG. 6 is an isometric view of an alternative embodiment of theinvention.

FIG. 7 is an isometric view of an alternative embodiment of theinvention.

FIG. 8 is an isometric view of an alternative embodiment of theinvention.

FIG. 9 is a side view of a driver device coupled to the stabilizingdevice.

FIG. 10 is an isometric view of a functional spinal unit with theposterior elements removed.

FIGS. 11A, 11B, and 11C show the rotation of a stabilizing device andtranslocation of local bone from the endplates of adjacent vertebralbodies.

FIG. 12A shows a spinal unit with pre-delivery horizontal cuts.

FIG. 12B shows an implanted stabilizing device prior to rotation.

FIG. 13 shows alternative delivery method utilizing cylindrical boringdevice.

FIG. 14 is a sagittal view of an ankle joint.

FIG. 15 is a posterior view of an ankle with an implanted stabilizingdevice.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

Several embodiments of present invention involve stabilizing devices andmethods that immobilize adjacent vertebral bodies or other selectedjoints. One or more of the embodiments, a stabilizing device, orimplant, is provided to re-establish and maintain proper alignment anddistance between the adjacent vertebrae and to serve as a spacer orfusion cage. The shape of the stabilizing device offers sufficientsurface area to offer initial resistance to axial compression betweenthe adjacent endplates and over time, as fusion progresses, even greaterresistance. Several embodiments of the present invention areparticularly advantageous because they offer pain relief. In oneembodiment, pain caused by spinal stenosis or by degenerated orherniated disc tissue is ameliorated or eliminated via discectomy andreestablishment of proper vertebral spacing. In another embodiment, paincaused by degenerated facet joints and pathological increased range ofmotion is reduced.

In one embodiment, the methods of autograft bone harvest andimplantation are combined. Here large hunks or plates (as compared tosmall chips) are cleaved from a proximal bony surface as the stabilizingdevice is inserted between the vertebral bodies. Large chunks of bonewith sufficient surface area and structural integrity are harvested. Thesite in which one or more of the grafts are harvested are also“prepared” in that the bone surface is scraped, or otherwisemanipulated, to stimulate a healing response and promote fusion. Byselecting local bone (and not bone from, for example the hip whichrequires addition incisions and site preparation and closing) andcombing the harvesting step with the implantation step, severalembodiments of the invention provide several benefits. These benefitsinclude, but are not limited to, decreased operation time, increasedsurgical efficiency, patient acceptance of the stabilizing device, andeffectiveness of the fusion. Although, in a preferred embodiment largeportions of local bone are cleaved, one of skill in the art willunderstand that smaller bone fragments and/or non-local bone from othersites can be used in accordance with several embodiments of the presentinvention.

Reference is now directed at FIG. 1, which is a sagittal view of afunctional spinal unit 100 comprising a superior vertebral body 1, ananulus fibrosus 3 connected to an adjacent inferior vertebral body 2.Posterior elements of the vertebral bodies include a spinous process 4,transverse process 4 and facet joint 6. Each vertebral body has aninferior 7 and superior endplate 8 which along with the anulus fibrosus3 bounds the nucleus pulposus.

FIG. 2 shows the functional spinal unit of FIG. 1, with a herniated disc200. Here the collagenous fibers of the anulus fibrosus 3 have brokenand nucleus pulposus and anulus fibers have entered the space normallyoccupied by the nerves of the spinal canal.

FIG. 3 shows a front cross-sectional view of a functional spinal unit100. The endplates 7, 8, 9, 10 are comprised of dense cortical bone nearthe periphery of the endplates and more porous and flexible cancellousbone towards the center. Within each vertebral body 1, 2 is marrow 12.The anulus 3 and nucleus pulposus 11 are also shown.

FIG. 4A represents an isometric view of one embodiment of the invention.FIG. 4A shows a stabilizing device, or implant, comprising an elongatedbody 14 and first 16 and second 18 opposing bone cutting surfacesseparated by the width of the elongated body 14. Alternatively the bonecutting surfaces could simply be connected by one or more struts orsupport members instead of the elongated body. Each bone cutting surfacecan have four sharpened edges or portions sharpened thereof such on ormore of the leading, trailing, and horizontal edges of the bone cuttingsurfaces. In several embodiments, the first bone cutting surfaces 14and/or the second bone cutting surfaces 16 is comprised of a pluralityof bone cutting surfaces. In one embodiment, the first bone cuttingsurface 14 and second bone cutting surface 16 are each configured of twoseparate bone cutting surfaces, e.g., an upper bone cutting surface anda lower bone cutting surface. In one embodiment, the bone cuttingsurfaces are blades or blade-like surfaces. As shown in FIG. 4A, theelongated body 14 has a first bone cutting surface 16 and a second bonecutting surface 18 that are offset from the longitudinal axis of thebody 14. The first bone cutting surface 16 faces in a first direction,and the second bone cutting surface 18 faces in a second direction. Thefirst bone cutting surface 16 and/or the second bone cutting surface 18is adapted to cut bone upon rotation of the body 14 about itslongitudinal axis between two adjacent bones.

FIG. 4B and FIG. 4C show front views of different cross-sections of oneembodiment of the device. FIG. 4B shows an “H”-like cross-section withstraight bone cutting surfaces 20, 22, comprising bards or roughenedsurface to fix bone grafts. FIG. 4C shows curved bone cutting surfaces24, 26 to trap and/or fix bone graft material. In one embodiment, a“T”-like cross-section is provided.

FIG. 5 is an isometric view of one embodiment of the invention showingan elongated body with a first bone cutting surface 116 and second bonecutting surface 118. The body 114 is at least partially hollow. In oneembodiment, the hollowed portion is adapted to accept graft material orother biocompatible material. In one embodiment, the hollow bodyfacilitates rotation of the stabilizing device. In embodiments where thebody is not hollow, a hex-shaped insert may be cut-out of the body tofacilitate rotation with compatible rods and tools. In some embodiments,the elongated body is a support member that serves to connect two bonecutting surfaces.

In one embodiment, a portion of a bone cutting surface and/or theelongated body includes at least one shearing means or protrusion.Protrusions include, but are not limited to, barbs, spikes and wedges.In some embodiments, a portion of a bone cutting surface and/or theelongated body is treated with a surface treatment, such as bone growthfacilitator (e.g., bone morphogenic protein) and/or adhesives (e.g.,cyanoacrylate). In one embodiment, the implantable stabilizing devicefurther includes a source or supply of bone growth facilitator. Bonegrowth facilitator aids in the promotion of bone growth and/or stabilityand, in some embodiments, can accelerate bone fusion and decreasepatient recovery times.

FIG. 6 shows a hollow elongated body 214, comprising one or moreperforations, holes, or voids. The first bone cutting surface 216 and/orthe second bone cutting surface 218 also comprises one or moreperforations, holes, or voids. One function of the perforations, holes,or voids is to permit bone ingrowth and promote fusions. In oneembodiment, at least one of the cutting surfaces or the body is at leastpartially porous. The porous material, and the perforations, holes, orvoids, are also advantageous because they permit the infusion or passageof bone growth facilitator to the required sites.

FIG. 7 expands on the concept depicted in FIG. 6 by removingsubstantially all of the elongated body to leave a body 314 comprisingof a leading support member 328 and trailing support member 330, shownhere with rectangular voids. One of skill in the art will understandthat the voids can be of any shape suitable to accomplish the desiredpurpose, including, but not limited to, rectangular, square, triangular,oval or circular-shaped voids. In one embodiment, the first bone cuttingsurface 316 and/or the second bone cutting surface 318 have sharpenedhorizontal edges 20′, 20″ and can be rotated up to 360 degrees and serveto scoop, bore or core out an entire graft segment, or portions thereof.In another method, the device 500 can be rotated in the range of about90 degrees to about 180 degrees.

FIG. 8 shows one embodiment of the device with the first bone cuttingsurface 416 and second bone cutting surface 418 comprising one or morevoids in the body 414 and/or bone cutting surfaces 416, 418. In oneembodiment, two or more voids along the horizontal edges 20′, 20″ createteeth 432, 434. In one embodiment, each bone cutting surface 416, 418has a horizontal edge 20 with leading 432′, trailing upper teeth 432″,and leading 434′ and trailing 434″ lower teeth. One skilled in the artwill understand that fewer or more teeth can be used in accordance withseveral embodiments of the present invention.

FIG. 9 shows a side view of one embodiment of the stabilizing device 500coupled to a driver 550. The stabilizing device, or implant, comprises aleading edge 510 and a horizontal edge 520. The coupling, engagement orconnection can be a socket and sleeve, friction fit, clamp, or otherconnection known in the art. The driver 550 can be used as a site toapply the force of a hammer, or other like tool, to cut through thevertebrae of a herniated spine unit 200 and later as a site to applyrotational force 510 by hand or machine. According to severalembodiments of the invention, the stabilizing device 500 can be a uni-or multi-component construct of biocompatible material. For example theentire stabilizing device 500, or portions thereof, could be constructedfrom titanium or steel, or some combination thereof. Alternatively,other metals and alloys could be employed for the bone cutting surfacesand coupled to plastic, ceramic, or other biocompatible materialcomprising the connection member or elongated body. Accordingly, variousembodiments of the invention can be constructed from ceramics, metals,plastics, composites or any suitable biocompatible material andcombinations thereof.

As discussed above, in several embodiments, various sharpened and bluntprotrusions along the length and faces of the bone cutting surfaces andoff of the central body of the stabilizing device can be used forshearing and cutting. For example, the sharpened protrusions on theleading edge of the bone cutting surfaces can be used to facilitatestraight shearing or cutting as the stabilizing device is hammered inplace prior to the rotational shearing by the blunt or sharpenedhorizontal edge. The shape of the bone cutting surface and itsorientation with respect to the elongated body or connection members canbe adapted to hold or keep harvested autograft in place by angling thebone cutting surfaces less than 90 degrees relative to the body or bycurving them in ward. Barbs or surface roughness along the bone cuttingsurfaces and body may also be used to fix the graft to the stabilizingdevice.

Dimensions and Size Range

In several embodiments, the stabilizing device can be properly sizedfrom precise dimensions of the intervertebral disc geometry of theindividual selected for treatment. One skilled in the art willunderstand that these dimensions can be culled from CAT scan data orsimilar data from another modality. For example, scans can be used todetermine the proper or normal distance between adjacent vertebralbodies and this distance can be used to approximate the height of thestabilizing device. Similarly, data from scans depicting the internaldimensions of the anulus and endplates (in a neutral position) can beused to design the outer shape of the device so that after harvestingbone along the endplates and rotating the stabilizing device, a precisefit is achieved. In one embodiment, the device has a width in the rangeof about 0.25 cm to about 7 cm, preferably between about 0.5 cm to about6 cm, more preferably between about 1 cm to about 5 cm. In oneembodiment, the device has a length in the range of about 0.25 cm toabout 5 cm, preferably between about 0.5 cm to about 4 cm, morepreferably between about 1 cm to about 3 cm. In one embodiment, multiplestabilizing devices are stacked between the same two vertebral bodies.Such stacking, in some embodiments, aid in stability and allow for theuse of smaller stabilizing devices.

Delivery Method

In one embodiment of the present invention, a method of initiating bonyfusion between a first bone and a second bone is provided. In oneembodiment, an implant having a body with a longitudinal axis, and atleast a first bone cutter and a second bone cutter offset in oppositetransverse directions from the longitudinal axis is provided. Theimplant is introduced between the first and second bones and rotatedabout its longitudinal axis so that the first and second bone cutterscut fragments from the first and second bones. The implant is left inposition between the first and second bones. In some embodiments, asecond implant is inserted in between the first and second bones. In oneembodiment, bony fusion is initiated between adjacent vertebral bodies.In one embodiment, at least one of the first and second vertebral bodiesis in the sacral spine, lumbar spine or cervical spine. In oneembodiment, the implant is rotated through no more than one revolution.In another embodiment, the implant is rotated through no more than about120 degrees. In another embodiment, rotation is stopped at a point wherethe first bone cutter is in contact with the first bone and the secondbone cutter is in contact with the second bone.

In one embodiment, bone growth facilitator is infused through at least aportion of the implant. Bone growth facilitator can be introduced viaone or more lumens in the boring instrument or rods, described below, orcan be introduced using a separate insertion device. In one embodiment,bone growth facilitator is an integral part of the stabilizing device.In some embodiments, the stabilizing device, or implant, is coupled to asource of bone growth facilitator. In alternative embodiments, theimplant is pre-treated with bone growth facilitator.

In several embodiments, more than one stabilizing device is used. In oneembodiment, two stabilizing devices are used. In another embodiment,three stabilizing devices are used. In one embodiment, a stabilizingdevice as described herein is used in connection with one or morestructural devices, such as screws, that are used to stabilize the spacebetween two bones by restricting movement.

In one embodiment, insertion of the stabilizing device is performedusing an anterior approach, though a lateral approach can also be used.FIG. 10 shows an isometric view of the posterior of a functional spinalunit 100 comprising a superior vertebral body 1, inferior vertebral body2, an anulus 3, a transverse process 4, and portion of a facet joint 6.The other posterior elements have been surgically removed. In thisembodiment, a posterior approach can be used.

In one embodiment, arthroscopic equipment known in the art may be usedto perform a partial or complete discectomy to provide an initialimplantation site. A distraction device can then be used to provideaccess to the intervertebral space and allow for precise delivery.Alternatively, the stabilizing device itself can be designed with awedge profile and forcibly inserted across the endplates therebydistracting them. An insertion rod can engage or be placed against thedistal or trailing side if the device and used to push the device or asa site to apply the force of a hammer.

In an alternative delivery method, the stabilizing device can be usedwithout performing a discectomy or distracting the endplates. In thisembodiment, the leading edges of the bone cutting surfaces of thestabilizing device are also sharpened and used to cut straight into thevertebral bodies (across to the endplates) as the stabilizing device isdriven between and parallel the adjacent endplates. As the stabilizingdevice is inserted, a hollow mid-section of the central body can acceptthe displaced disc material in between.

FIGS. 11A-C show a method of delivery according to one embodiment of theinvention. Following the initial implantation between the vertebralbodies 7, 8, one or more drivers 550 or insertion rods are engaged tothe device and used to impart axial rotation (driver is not shown)causing the bladed edges of the stabilizing device along its length togouge and shear off portions of the adjacent endplates 7, 8. Theseportions are then forced into the adjacent hollow receiving zones of thestabilizing device. Barbs or other means, including, but not limited tospikes, wedges, surface treatments, adhesives (e.g., cyanoacrylate) orsome combination thereof, may be used along the stabilizing devicesurface, or portions of the stabilizing device surface, to retain theharvested bone 600.

After rotation through approximately 90 degrees, the driver 550 orinsertion rod is removed. In this orientation, the harvested bone 600contacts the sidewalls and edges of both vertebrae that now have freshlyscraped osteogenic surfaces. The curved and sharpened edges of thestabilizing device lie substantially parallel to the endplates and theharvested bone is flush with or extends beyond their edges to reduce orprevent further cutting or physical trauma. In one embodiment, a hollowstabilizing device (as shown in FIG. 7) is used to fully shear throughthe bone in one or more partial or complete revolutions.

FIG. 12A and 12B show an alternative delivery method in which an initialstep is added prior to inserting the stabilizing device. Here one ormore horizontal holes or slots 905 are punched above each of theendplates as shown. The stabilizing device 500 is hammered into placethrough the endplates and across the disc space. One advantage of thisstep is that it facilitates rotation of the stabilizing device 500 (anddisplacement of the bone grafts).

FIG. 13 shows a cylindrical boring instrument 900 and the cut 910 itmakes into the vertebral bodies 1, 2. After the bore 900 has beenremoved, a device 500 with or without sharpened edges may be insertedand rotated, as described above.

In one or more embodiments discussed herein, initial fixation can beachieved through one or more of vertebral taxis (caused be the tensionof the remaining anulus fibers), wedging action and friction. Secondaryor permanent fixation via fusion occurs over a period of weeks as theportions of the harvested bone in the stabilizing device fuse to eachother and the adjacent vertebrae until eventually the stabilizing deviceis encapsulated.

In one embodiment of the invention, stabilizing devices of varying sizesand geometries are used to fuse other pathological joints of the body.These joints include, but are not limited to joints of the shoulder,wrist, ankle, knee, hip, and digits. FIG. 14 shows a sagittal view of anankle joint, including fibula 980, tibia 986, talus 988 and calcaneus982.

FIG. 15 shows the ankle bone with an implanted stabilizing device 500.The stabilizing device 500 is used to fuse an ankle joint. In thisembodiment, the stabilizing device is inserted along the bones andcartilage between the tibia 986, talus 988, calcaneus 982, an/or fibula980. In one embodiment, the stabilizing device is implanted between twoor more adjacent bones.

While this invention has been particularly shown and described withreferences to preferred embodiments thereof, it will be understood bythose skilled in the art that various changes in form and details may bemade therein without departing from the scope of the inventionencompassed by the appended claims. Additionally, it will be recognizedthat the methods described herein may be practiced using any devicesuitable for performing the recited steps. Such alternative embodimentsand/or uses of the methods and devices described above and obviousmodifications and equivalents thereof are intended to be within thescope of the present disclosure.

1. An implantable stabilizing device for stabilizing a joint in thehuman body comprising: an elongate body having an upper surface and alower surface, wherein said upper and lower surfaces having alongitudinal axis and transverse axis; a first pair of opposingblade-like shearing protrusions extending from said upper surface of theelongate body; a second pair of opposing blade-like shearing protrusionsextending from said lower surface of the elongate body, wherein saidfirst pair of blade-like shearing protrusions comprises a leading edgeand a trailing edge, and wherein said second pair of blade-like shearingprotrusions comprises a leading edge and a trailing edge.
 2. The deviceof claim 1, wherein at least one of said first pair or second pair ofblade-like shearing protrusions extend away from the elongate body at anangle less than about 90 degrees relative to the transverse axis of theelongate body to facilitate containment of a harvested bone material. 3.The device of claim 1, wherein at least one of said first pair or secondpair of blade-like shearing protrusions are curved to facilitate thecontainment of harvested bone.
 4. The device of claim 1, wherein atleast one of said first pair or second pair of blade-like shearingprotrusions comprises barbs.
 5. The device of claim 1, wherein at leastone of said first pair or second pair of blade-like shearing protrusionscomprises one or more perforations, holes, or voids.
 6. The device ofclaim 5, wherein said one or more perforations, holes, or voids permitbone ingrowth.
 7. The device of claim 1, wherein at least one of saidfirst pair or second pair of blade-like shearing protrusions comprises aporous portion.
 8. The device of claim 7, wherein said porous portionpermits bone ingrowth.
 9. The device of claim 1, wherein at least aportion at least one of said first pair or second pair of blade-likeshearing protrusions is coated with a bone growth facilitator.
 10. Thedevice of claim 1, wherein said first pair and second pair of shearingprotrusions extend along said upper and lower surface of the elongatebody at an angle parallel to the transverse axis of the elongate body.11. The device of claim 1, wherein said wherein said first pair andsecond pair of shearing protrusions are oriented along said upper andlower surface of the elongate body such that said shearing protrusionspairs form a wedge.
 12. The device of claim 1, wherein the elongate bodycomprises a hollow portion.
 13. The device of claim 12, wherein thehollow portion is adapted to accept bone that is sheared by at least oneof said first pair or second pair of blade-like shearing protrusions.14. The device of claim 1, wherein the elongate body comprises one ormore perforations, holes, or voids.
 15. The device of claim 14, whereinsaid one or more perforations, holes, or voids permit bone ingrowth. 16.The device of claim 1, wherein the elongate body comprises a porousportion.
 17. The device of claim 16, wherein said porous portion permitsbone ingrowth.
 18. The device of claim 1, wherein at least a portion ofthe elongate body is coated with a bone growth facilitator.